Nepalese Journal of Ophthalmology最新文献

Background: Aetiology for non-closure of full-thickness macular hole (FTMH) becomes crucial in determining the method of effective mode of intervention. Association of epiretinal proliferation (ERP) along with full-thickness macular hole (FTMH) have shown poorer anatomic and visual outcomes after surgical intervention. Various surgical techniques have been described in literature for treatment of persistent MH.

Case: We report a A 60-year-old female patient with FTMH secondary to branched retinal vein occlusion (BRVO) initially associated with ERP.

Observations: She was successfully managed by treating with combination of intravitreal injection of off label bevacizumab (Avastin) (1.25 mg/0.05 ml) and pure gas of SF6 (1 cc) under topical anaesthesia after an initial surgical intervention.

Conclusion: Presence of ERP in retinal vein occlusion cases needs closer and frequent follow up. IVB can be used as an adjunct in treating secondary MH.

Introduction: Accurate refractive error assessment is the first and the most important step of ocular examination. A reliable screening method of refractive status is important for early detection and prevention of blinding complications of uncorrected refractive error.

Objectives: To evaluate the comparability of astigmatism measured by an auto-refractometer (URk-800F) with the measurements of the gold standard anterior segment optical coherence tomography (AS-OCT).

Materials and methods: This cross-sectional observational study was conducted in a tertiary eye centre in Kathmandu from February 2023 to June 2023. A total of 100 patients with best corrected visual acuity of ≥ 20/20, spherical refractive error with cylindrical error of more than and equal to -0.75 and no pathology detected on slit lamp examination were taken by consecutive sampling method. Ethical approval was taken for the study. The data were entered into Microsoft Excel and analysed using Bland-Altman analysis.

Results: The mean cylindrical power and axis was -2.33 D and 88 degrees for the right eye and -2.32 D and 122 degrees for the left eye respectively, as measured by MS-39 AS-OCT. For URK 800-F Auto-refracto Keratometer, the mean cylindrical power and axis was -2.31 D and 89 degrees for the right eye and -2.27 D and 124 degrees for the left eye.

Conclusion: The findings of this study conclude that an auto-refractometer can be used as an effective tool for identification of spherical refractive error as well as measurement of accurate cylindrical power and cylindrical axis in low resource primary care settings.

Introduction: Many ocular or systemic conditions can cause weakening of the zonules, leading to subluxation or complete dislocation of lens into the anterior chamber or vitreous cavity.

Objectives: To evaluate the outcome of surgery in cases with subluxated and dislocated lens.

Materials and methods: Retrospective chart review of all cases with subluxated and dislocated lens who underwent surgery in a one-year period from 2019 January to 2019 December was conducted. Demographic profile, systemic comorbidities, initial and final best corrected visual acuity (BCVA), surgical procedure were recorded along with all the intraoperative and post-operative complications.

Results: A total of 62 eyes of 60 patients with mean age of 50.18 ± 15.18 years (18 to 87 years) were included with the modal duration of presentation of one week. Among these, trauma was found to be the most common etiology. Subluxation was present in 55 eyes and seven eyes had dislocation. Intracapsular Cataract Extraction (ICCE) was performed in 41 while 21 underwent Extracapsular Cataract Extraction (ECCE); and surgical intervention elicited a statistically significant (p < 0.05) improvement in the visual acuity. The BCVA was statistically better among the pseudophakic patient. Most common complication encountered intraoperatively was vitreous loss and post operatively was significant corneal edema.

Conclusion: Cataract extraction in cases with subluxated and dislocated lens due to different etiology results in the improvement in the visual acuity of the patient. In cases where ECCE cannot be performed, ICCE also results in comparable visual improvement.

Background: Bilateral optic neuritis following enteric fever is a rare condition requiring early evaluation by an ophthalmologist and prompt treatment for visual rehabilitation.

Case: A 31-year-old female diagnosed with enteric fever presented to the Neuro-ophthalmology department with sudden painful loss of vision in both eyes for 10 days.

Observations: Her Best Corrected Visual Acuity (BCVA) was counting fingers close to face in left eye and 6/18 in right eye. Posterior segment examination showed blurring of disc margin on both eyes. On Magnetic Resonance Imaging (MRI) of brain and orbit there was mild thickening of retro-orbital portions of both optic nerves. She was started on steroid therapy which resulted in marked improvement of vision in both eyes.

Conclusion: Optic neuritis following enteric fever is a rare entity and requires early diagnosis with prompt treatment for improvement of visual acuity and prevention of visual impairment.